Resident fell, now I'm fired

[gonegirl]

I did something stupid, and now am paying for it.

What happened:

I work the overnight (11-7) shift at a LTCF. There are 2 aides(me & 1 other) plus a nurse on staff, for a total of 30 residents, many who have alarms due to wandering, Alzheimer's/dementia. Many of the residents I care for stay awake well until 3 am, asking to be toileted, etc. There is an hour of lull time, and at 4 the lights start again. I often have full bed changes on my first set of rounds, and 11 of my residents are completely incontinent of both urine and feces, and 2 of the others ring every half hour to an hour to go be toileted, one who has an alarm and cannot be left in the restroom. I am expected to get up 4 residents(varying with the therapy schedule, which does not necessarily coincide with the resident's sleep habits) plus give a resident a shower between the hours of 6-7am, and the aide on the other side is expected to do the same. (wake up anyone before 6, and there is disciplinary action.) If get-ups are not complete, there is a problem. My nurse always tells me she is on break from 5-5:45, at which point I am completing my final rounds before get-up, and she starts her med pass immediately after.

The other night, I started my rounds on the late side, because I was helping the supervisor with a project (during my 3-4 lull). I start my rounds at about 4:30, having checked if my two assists are wet, so that I will be able to get assistance from the other aide on the floor, as the nurse will not help. My coworker has more two assists to change on her side than the last time I had worked, so I am much further behind than usual. At about 5:30, one of my two assists rings, and I find her in a pool of liquid feces. She was dry until this point. My co-worker is currently in the shower room with a fall-risk patient who keeps getting up. My nurse is on break. I keep thinking how I can't leave her in a pool of liquid feces, and attempt to change her myself. (first mistake) Unfortunately, the facility where I work does not have side rails, which I sometimes forget, and roll the resident away from myself. (We had side rails in my training program, and the last place I worked) This was my mistake 2. I feel horrible, the resident fell and hurt herself. Now I am fired for breaking the care plan, and an injury happening.

I don't know what I want you all to say. I already feel like a moron, and like I don't deserve any sympathy. I guess I am just wondering if there is any chance of me finding another job as a cna, or in medicine period, or if I should just give it up. I really enjoyed my job until I had to come to the facility I was just fired from, and residents were always verbally appreciating how gentle/patient/responsive I was, even at this new facility, where many of the aides are gruff. I guess I just needed to spew at people who would possibly get it, and have some helpful input, other than, "yeah, you screwed up." Thanks for reading.

[Missingyou, CNA]

Yes, you have a chance of finding other work as a CNA in another facility. At your next interview when they ask why you left the last employer be honest with them. Tell them in as few words as possible that a resident fell while in your care because you attempted to provide care on your own when they were a 2 assist. Make it a point that you learned from your mistake and that you will NEVER repeat that same mistake and the care plan will always be followed.

Don't beat yourself up too much. Live and learn. That's what life is.

[Adele_Michal7, ASN, RN]

I think they made a mistake to fire you. Falls happen. As a nurse i collaborate with my unit manager to review falls and put programs in place to reduce the number. But they happen. What's more important is how staff responds to a fall. It sounds like you followed policy. If this LTC fires everyone involved in every fall they will soon find themselves with no one.

[RN403, BSN, RN]

I think it was extreme to fire you. As a PP stated, if they continue to fire everyone who is involved in a resident fall, they will be left with no staff. I am sure you will be able to find future employment....sounds like you were trying to do what was best for your resident with the resources available at the time.

Best wishes.

[AlwaysLearning247, BSN]

Everyone makes mistakes and it is not worth beating yourself up over. You will find another job. I know how difficult it can be as a CNA in LTC, I was one in nursing school for a while. There is so much to do and sometimes you are so short staffed. Just learn from this experience and you will be okay. They should have given you another chance, stuff happens. I've seen it happen at the nursing home I worked at. Just in the future don't do anything you are not comfortable with, even if it will delay the care. It is better to be safe than sorry. Good luck! You sound like a great CNA and I think they made a mistake letting you go. You sound like you care for the residents very much.

[Red Kryptonite]

Is anyone else wondering about the nurse who takes a 45 minute break during one of the busiest times in the shift? And refuses to help with patient care when she is one of ONLY THREE people in the building?

[OrganizedChaos, LVN]

Is anyone else wondering about the nurse who takes a 45 minute break during one of the busiest times in the shift? And refuses to help with patient care when she is one of ONLY THREE people in the building?

That was my *first* thought.

[Purple_roses]

Let me just say that I am so sorry this happened to you. Was it safe to attempt to help your resident by yourself? No, but you had the best of intentions. I would also feel badly about leaving someone in their own waste. You were trying to do a good thing. I also think it's strange that your facility does not have bed rails. I personally think this facility was wrong to fire you. Falls happen. People have fallen on my shift--it's such a horrible feeling when it happens. I really feel for you OP.

[Purple_roses]

Is anyone else wondering about the nurse who takes a 45 minute break during one of the busiest times in the shift? And refuses to help with patient care when she is one of ONLY THREE people in the building?

Yes. From start to finish, it sounds like this particular facility is a disaster waiting to happen.

[truthteller]

You did the right thing. The responsibility lies with the fool who decided 2 CNAs for 33 patients was adequate. Based on your description I can make an educated guess who you worked for. Leave them behind and move on. You're a better CNA for having learned and they're an even more unsafe facility for losing you. Now, they have 1 NOC CNA for 33 patients and a trainee if they're lucky. State and federal nursing laws should define a specific limit regarding nurse/aide to patient ratios. I believe 8 patients per CNA should be the highest. Any more than 8 is unsafe practice by the management.

[gonegirl]

Thank you for your kind words, everyone. I am applying for jobs starting tomorrow, and you have helped me bolster my shattered confidence.

[jojo489]

Is anyone else wondering about the nurse who takes a 45 minute break during one of the busiest times in the shift? And refuses to help with patient care when she is one of ONLY THREE people in the building?

This is not at all uncommon in LTC. I'm ashamed to say I know more nurses than I can count who don't help their CNAs, even with that type of ratio. I hated that, and very often voiced my opinion to nurses who would spend ten minutes trying to find an aide to get someone a cup of ice water.

OP, don't be down on yourself. Count it as a lesson learned.

We had a lot of falls in my facility as well, we did not have side rails at all because of the whole restraint issue. And we had very poor ratios, I worked on a 60 bed unit and we would only have two nurses and 3 aides at night....they would even allow day shift to run with as little as 2 nurses and 4 aides, if there was a call off.